Infertility and Risk of Breast, Gynecologic, and Colorectal Cancer

不孕症和乳腺癌、妇科癌和结直肠癌的风险

• 批准号: 10215755
• 负责人: Leslie V Farland
• 金额: $ 7.68万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10215755
• 关键词: Address; Affect; Age; Age at Menarche; Androgens; Attention; Breast; Breast Cancer Risk Factor; Breast Feeding; Characteristics; Chronic Disease; Clinical; Clinical Research; Colorectal; Colorectal Cancer; Complex; Conceptions; Couples; Data; Data Sources; Diagnosis; Endometrial; Endometrial Carcinoma; Etiology; Fertilization in Vitro; First Births; Follow-Up Studies; Goals; Heterogeneity; High-Risk Cancer; Hormonal; Incidence; Infertility; Inflammation; Inflammatory; Knowledge; Malignant Female Reproductive System Neoplasm; Malignant Neoplasms; Malignant neoplasm of ovary; Menopause; Ovarian; Ovarian hormone; Pathway interactions; Population; Postmenopause; Pregnancy; Premenopause; Prevention; Prospective cohort; Public Health; Recommendation; Recording of previous events; Registries; Reproductive History; Research; Risk; Risk Factors; Sampling; Time; Tube; United States; Unsafe Sex; Uterus; Woman; Women' s Health; adverse pregnancy outcome; cancer risk; cohort; colorectal cancer risk; endometriosis; ethnic diversity; experience; follow-up; high risk; hormone related cancer; improved; inflammatory milieu; male; malignant breast neoplasm; mortality; parity; parous; prospective; racial and ethnic; racial diversity; reproductive; risk prediction; trying to conceive; tubal infertility

Project Summary/Abstract Infertility burdens 10-15% of couples in the United States. Women suffering from infertility may be at increased risk of chronic diseases, including cancer. A variety of pathways have been implicated in the association between infertility and cancer risk, including aberrant hormonal (e.g., excess androgens among women with ovulatory infertility) and inflammatory environments (e.g., excess inflammation among women with endometriosis, tubal factor infertility). Additionally, the underlying etiology of the infertility may modify cancer risk, with some infertility diagnoses conferring higher cancer risk (e.g., endometriosis and ovarian cancer risk) and others conferring lower risk (e.g., ovulatory infertility and breast cancer). Research on the association between infertility and cancer has been limited to mostly small clinical studies, mechanistic studies, and registry studies with short durations of follow-up; all of which focus predominately on premenopausal cancer incidence and have been conducted among populations with limited racial/ethnic diversity. Moreover, insufficient attention has been paid to differences in infertility diagnosis. Thus, there are significant gaps in our knowledge regarding the complex association between infertility and cancer risks. The proposed research will focus on breast, ovarian, endometrial, and colorectal cancers, as these cancers have established hormonal and inflammatory risk factors and have some of the highest incidence and mortality. We will analyze the data collected in the Women’s Health Initiative (WHI)—a large, validated cohort that includes over 160,000 postmenopausal women with long follow-up duration (over 25 years), and strong racial/ethnic diversity within the sample population. Using these secondary data, we will determine whether women who have experienced infertility have increased risk for specific cancers compared to parous women who never experienced infertility and how this risk varies by infertility diagnosis. As approximately one in six women experience infertility and nearly 85% of cancers in women occur after menopause, there are critical public health implications for understanding the relationship between infertility history and risk of these cancers among postmenopausal women.

项目概要/摘要 不孕不育给美国 10-15% 的夫妇带来负担 患有不孕不育的女性可能会增加。 多种途径与慢性疾病（包括癌症）的风险有关。 不孕不育和癌症风险之间的关系，包括荷尔蒙异常（例如患有癌症的女性体内雄激素过多） 排卵性不孕）和炎症环境（例如患有以下疾病的女性过度炎症） 此外，不孕症的潜在病因可能会改变癌症。 风险，一些不孕症诊断会带来更高的癌症风险（例如子宫内膜异位症和卵巢癌风险） 以及其他风险较低的因素（例如排卵性不孕和乳腺癌）。 不孕症和癌症之间的关系仅限于小型临床研究、机制研究和 随访时间短的登记研究主要集中于绝经前癌症； 发生率，并在种族/族裔多样性有限的人群中进行。 对不孕症诊断差异的关注不够，因此，我们的诊断存在很大差距。 拟议的研究将了解有关不孕症与癌症风险之间复杂关联的知识。 重点关注乳腺癌、卵巢癌、子宫内膜癌和结直肠癌，因为这些癌症已经建立了激素 和炎症危险因素，其中一些发病率和死亡率最高。我们将分析这些数据。 女性健康倡议 (WHI) 中收集的数据——这是一个经过验证的大型队列，其中包括超过 160,000 名女性 随访时间长（超过 25 年）的绝经后妇女，并且种族/民族多样性很强 使用这些二手数据，我们将确定样本人群是否经历过这种情况。 与从未经历过不孕症的已产女性相比，不孕症会增加患特定癌症的风险 以及这种风险如何因不孕症诊断而变化。大约六分之一的女性经历不孕症和不孕症。 近 85% 的女性癌症发生在绝经后，这对公共健康具有重要影响 了解绝经后不孕史与这些癌症风险之间的关系 女性。